There has been an outbreak of Clostridium difficile bacteria in the Niagara area (St. Catharines, Welland and Niagara Falls ) and unfortunately there have been sixteen (16) deaths which the region’s health care system was not quick to reveal to the public.
This isn’t the first time we have experienced an outbreak of a viulent strain of C. difficile. In June, 2003 there were outbreaks in Calgary and Montreal which resulted in many deaths. Technology to combat the spread of this bacterium has improved in the last eight (8) years, making it easier to identify this bacterium and to isolate patients from the general population, preventing further spread.
Approximately two-hundred (200) people in Ontario die every year from C. difficile, which causes severe diarrhea and travels from person to person through hand contact.
This antibiotic-resistent superbug is extremely contagious and is normally transmitted through the hands. Hospital staff must wear gloves when treating patients with C. difficile or the risk of further transmission of the bacteria exists.
This superbug has been around the Province for many years now. Technology has improved where clusters can be identified quickly and as a result, patients can be isolated to prevent a further spread.
Once someone has a C. difficile infection, it is difficult to treat with antibiotics, due to its’ antibiotic resistance. Many hospitals now practice “antibiotic stewardship” or “anti-microbial stewardship”. Doctors caution people, stating that strong antibiotics destroy the “good bacteria” in the body and when this bacteria is present, especially in elders, our bodies cannot fight off this bacterium.
Hospitals are insisting that people who are visiting their buildings in this area, rub alcohol products onto their hands upon entering the facility. Hospitals are not telling visitors that this bacteria which create heat resistent spores, are not killed by alcohol-based hand cleansers or general cleaning of surfaces. If a patient remains in a hospital up to two (2) weeks, there is a 13% chance of contracting C. difficile and if the patient stays in the hospital longer than four (4) weeks, there is a 50% chance of contracting C. difficile. Those that are at highest risk are the elderly or those with depressed immune systems suffering with weak hearts, stroke or acute kidney failure.
Disinfectants used for cleaning in hospitals are ineffective against C. difficile spores, and in some cases actually help the formation of spores. Disinfectants containing bleach are effective in killing the organisms.
This bacteria is passed from person to person via fecal matter to the hands to the mouth.
Surfaces in hospitals and nursing homes can contain the spores from this bateria.
Once someone touches these spores and then touch their mouths; the spores are ingested by the person and will travel down the stomach, unaffected by the acid in the stomach. These spores can germinate into vegetative cells in the colon and will multiply when introduced to bile acids.
The toxins produced by C. difficile can be seen in infected people and result in diarrhea and inflamation (bloating in the stomach area).
People who are most at risk are those with depressed immune systems and the elderly who are in hospital or nursing homes.
Clostridium difficile is a commensal bacterium of the human intestine in 2-5% of the population. Diarrhea is a telltale symptom of this bacteria in the body.
Niagara Falls City Councillor Wayne Gates said he was appalled four deaths occurred at the local hospital before the public was notified.
Perhaps the Provincial government should implement legislation which forces hospitals, health care facilities and nursing homes to notify the public of deaths due to a superbug – upon identifying the source. It may be bad for busine$$, but the public has a right to know.
The hospital network, will be using a corrosive disinfectant, as advised by a public health team brought in by the province.
Hospitals should not be allowed to be quiet or to contain the news about these level of deaths, all related to the same strain of bacteria. There should be guidelines applied fairly and consistently across the Province, which serves as the guiding principle of alerting the public when these types of deaths occur in their hospital network.
It is unlikely anything will change until after the October, 2011 Provincial election.
It is surprising to note that simple handwashing can prevent the spread of this horrific bacteria and can lead to the savings of many lives – especially the elderly and those whose immune systems are comprimised. Handwashing must be reinforced, especially after someone has defecated, as this bacteria is transmitted from person to person by the fecal-oral route.
Update: July 8, 2011 – Ontario asks for the Federal Government’s assistance
Update: July 8, 2011 – Three (3) more die in C. difficile outbreak – up to 20 deaths
Update: July 9, 2011 – Visitors refusing to wash hands not helping outbreak, health officials say
Update: July 11, 2011 – C. difficile: Is your family at risk?